Uykusuzluk ve anesteziden uyanma ve derlenme: prospektif gözlemsel çalışma

Amaç: Bu çalışmanın amacı uykusuzluk çeken hastaların anesteziden uyanma ve derlenmesinin daha erken mi geç mi olduğunu araştırmak Gereç ve Yöntem: Bu çalışma genel anestezi altında elektif üreteroskopi planlanan erişkin hastaları kapsamaktadır. Jenkins- Uyku Anketi (JSQ) kullanılarak hastalar iki gruba ayrıldı: Uykusuzluk Grubu ve Kontrol Grubu. Anestezi standardize edildi. Anestezi indüksiyonu sonrası desfluran 4-6 konsantrasyonda, nitröz oksit/oksijen (%40/60) konsantrasyonda ve akım 3 L dk¯¹olarak uygulandı. Noninvaziv kan basıncı, kalp hızı, periferal oksijen satürasyonu, end- tidal karbondioksit değerleri, inspire ve ekshale edilen desfluran konsantrasyonları, anestezi süresi, cerrahi süresi, göz açma zamanı, derlenme odasına transfer zamanı kaydedildi. Görsel Ağrı Skalası (VAS) ağrıyı değerlendirmek, Modifiye Aldrete Derlenme Skoru (MARS) derlenmeyi değerlendirmek için kullanıldı. Bulgular: Değerlendirme 25’i kadın, 55’i erkek olmak üzere 80 hasta ile yapıldı; Uykusuzluk grubunda 42, kontrol grubunda 38 hasta vardı. Demografik ve hemodinamik veriler gruplar arasında anlamlı farklılık göstermedi. Göz açma zamanı, derlenme odasına transfer zamanı, VAS ve MARS değerleri her iki grupta benzerdi. Operasyon süreleri 30 dakikanın altında ve 30 dakika ve üzeri olarak sınıflandırıldığında; uyanma, derlenme ve ağrı parametrelerinin karşılaştırılması açısından gruplar arası önemli farklılık görülmedi. Sonuç: Normal uyuyanlarla karşılaştırıldığında, uykusuzluk çeken hastaların anesteziden uyanma ve derlenme açısından farkları olmadığı sonucuna varıldı.

Anahtar Kelimeler:

Anestezi, uykusuzluk, uyku, perioperatif bakım, postoperatif ağrı

Insomnia and wake up and recovery from anesthesia: a prospective observational study

Purpose: The aim of this study was to investigate whether wake up and recovery from anesthesia is earlier or later in patients with insomnia. Material and Methods: This study included adult patients who were scheduled for elective ureteroscopy under general anesthesia. Using the Jenkins-Sleep Questionnaire (JSQ), the patients were separated into two groups: Insomnia Group and Control Group. Anaesthesia was standardized. After anesthesia induction, 4-6 % desflurane in nitrous oxide/oxygen (60-40%) concentration at flow of 3 L min¯¹ was administered. The parameters recorded were noninvasive arterial blood pressure, heart rate, peripheral oxygen saturation, end-tidal carbon dioxide values, inspiratory and expiratory concentrations of desflurane, anesthesia time, surgery time, time of eye opening, time of transfer to the recovery room. Pain was assessed with a Visual Analogue Scale (VAS) and recovery with the Modified Aldrete Recovery Score (MARS). Results: Evaluation was made of 80 patients, comprising 25 females and, 55 males, grouped as 42 patients in the insomnia group and 38 in the control group. The demographic and hemodynamic data were not significantly different between the groups. The time of eye opening, transfer to the recovery room, VAS and MARS values were similar in both groups. When operation times were classified as ˂ 30 min. and ≥ 30 min, no significant differences were determined between the groups in respect of wake up, recovery and pain parameters. Conclusion: Compared with normal sleepers, patients with insomnia showed no differences in respect of wake up and recovery from anesthesia.

Keywords:

Anesthesia, insomnia, sleep, perioperative care, postoperative pain,

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